Cockell Scarlet, Wang Herong, Benke Kelly S, Ware Erin B, Bakulski Kelly M
Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109, USA.
Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, 615N. Wolfe Street, Baltimore, MD, 21205, USA.
medRxiv. 2024 Aug 19:2024.08.15.24312018. doi: 10.1101/2024.08.15.24312018.
Dementia susceptibility likely begins years before symptoms. Early life has not been comprehensively tested for dementia associations.
In the US Health and Retirement Study (normal baseline cognition; n=16,509; 2008-2018 waves), 31 exposures before age 16 were retrospectively assessed with ten-year incident cognitive status (dementia, impaired, normal). Using parallel logistic models, each exposure was tested with incident cognition, adjusting for sex, baseline age, follow-up, race/ethnicity, personal/parental education.
14.5% had incident impairment and 5.3% had dementia. Depression was associated with 1.71 (95%CI:1.28,2.26) times higher odds of incident impairment, relative to normal cognition. Headaches/migraines were associated with 1.63 (95%CI:1.18,2.22) times higher odds of incident impairment. Learning problems were associated with 1.75 (95%CI:1.05,2.79) times higher odds of incident impairment. Childhood self-rated health of fair (1.86, 95%CI:1.27,2.64) and poor (3.39, 95%CI:1.91,5.82) were associated with higher incident dementia odds, relative to excellent.
Early life factors may be important for impairment or dementia, extending the relevant risk window.
痴呆易感性可能在症状出现前数年就已开始。早年生活与痴呆的关联尚未得到全面测试。
在美国健康与退休研究（基线认知正常；n = 16509；2008 - 2018年各波次）中，对16岁之前的31种暴露因素进行回顾性评估，并与十年期的认知状态（痴呆、受损、正常）进行关联分析。使用平行逻辑模型，对每种暴露因素与认知事件进行测试，并对性别、基线年龄、随访时间、种族/族裔、个人/父母教育程度进行调整。
14.5%的人出现认知受损，5.3%的人患有痴呆。与认知正常相比，抑郁与认知受损事件的发生几率高1.71倍（95%置信区间：1.28, 2.26）相关。头痛/偏头痛与认知受损事件的发生几率高1.63倍（95%置信区间：1.18, 2.22）相关。学习问题与认知受损事件的发生几率高1.75倍（95%置信区间：1.05, 2.79）相关。与健康状况极佳相比，童年自评健康状况为中等（1.86, 95%置信区间：1.27, 2.64）和较差（3.39, 95%置信区间：1.91, 5.82）与痴呆发生几率较高相关。
早年生活因素可能对认知受损或痴呆很重要，这扩展了相关的风险窗口期。
